Optimizing Behavioral Health Homes for Adults With Serious Mental Illness

Summary

Adults with serious mental illness (SMI) frequently have unmet medical needs which place them at risk for adverse health outcomes. While there are proven ways to manage and/or prevent serious medical conditions common among this population, information is needed to understand their impact on outcomes that matter most for patients, particularly in community mental health centers (CMHCs) where most adults with SMI receive their care and rural areas where locating and receiving health care services can be challenging.

The investigators will test two promising ways for promoting the health, wellness, and recovery of adults with SMI. One way will help patients manage their health and health care through self-management strategies, including the use of a web portal, and peer support (patient self-directed care) and the other through interactions with nurses during clinic visits (provider-supported integrated care).

The investigators will compare the two interventions on three primary patient-centered outcomes (i.e. patient activation in care, health status, engagement in primary/specialty care). The investigators hypothesize that:

1. Patient self-directed care will result in improvement in patient activation.
2. Provider-supported integrated care will result in greater improvement in frequency in primary/specialty care visits.
3. Both interventions will result in significant improvements in the three primary outcomes.

The investigators will collect information from patients, caregivers, and clinic staff at different points in time during the study. Patients will be asked to complete questionnaires and additional data on their service use will be gathered. Some patients and providers will also be interviewed about their experiences with care. The investigators will examine these data to learn if, how, and why the new services improve outcomes over time. This information will help us understand patient and other stakeholder views about the services and, if appropriate, ensure their continued and/or expanded availability.

Conditions

• Chronic Disease
• Mental Health
• Behavioral Health
• Cardiovascular Disease
• Diabetes Mellitus Type 2
• Substance-related Disorders
• Vascular Diseases

Interventions

BEHAVIORAL

Patient Self-Directed Care

Patient self-management toolkits, web portal with information on health conditions, personal health care use data, health tracking tools and wellness programs

BEHAVIORAL

Provider-Supported Integrated Care

Registered nurse on staff at community mental health centers with access to patient-level physical health information to: 1) work with patients on coordinating their care, 2) enhance communication between providers and payer, and 3) provide patient wellness support and education

Sponsors & Collaborators

• UPMC Center for High-Value Health Care

  collaborator UNKNOWN

• Western Psychiatric Institute and Clinic of UPMC

  collaborator UNKNOWN

• Community Care Behavioral Health Organization

  collaborator UNKNOWN

• Columbia Montour Snyder Union Mental Health

  collaborator UNKNOWN

• Behavioral Health Alliance of Rural Pennsylvania

  collaborator UNKNOWN

• University of Pittsburgh

  lead OTHER

Principal Investigators

• Charles F. Reynolds, MD · University of Pittsburgh; UPMC Center for High-Value Health Care

• James M. Schuster, MD, MBA · Community Care Behavioral Health; UPMC Center for High-Value Health Care

• Tracy A. Carney, AAS · Recovery Central Clubhouse, Columbia Montour Snyder Union Mental Health

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2013-10-31

Primary Completion

2016-10-31

Completion

2017-01-31

Countries

• United States

Study Locations